How Do the Different Types of Diabetes Influence Pregnancy Outcomes? Retrospective study from January 2017 to Dec 2018 at Khoula hospital

 

Abstract

Objective: The aim of our study was to determine the prevalence of diabetes in labouring women from January 2017 to December 2018 and compare the feto-maternal outcomes of GDM, Type 1 and Type 2 diabetes mellitus.

Methodology: A retrospective cohort of diabetic women in pregnancy who delivered at Khoula hospital were identified from the electronic medical record system in Khoula hospital, Muscat, Oman from January 2017 to December to 2018 and analysed for feto-maternal parameters.

Results: 11190 files were analysed, 2859 (25.5%) patients were identified to have diabetes. 437 patients were excluded and 2422 were selected. Overall prevalence of diabetes was 25.8%. 2062 (85.1%) had GDM, 329 (13.5%) NIDDM and 38(1.56%) had IDDM. Mean age was 32.8+/- 4.6yrs. The obesity rate in the cohort was 60.3% and overall mean BMI was 31.7+/- 5.2. Optimum control was achieved in 89.5% of women. Mean gestational age of delivery was 38+/- 1.2 wks. Macrosomia was seen in 5.7% and shoulder dystocia rate was 0.78%. 9.9% babies were born preterm overall. Overall induction of labor was 17.09% and caesarean rate was 27.4%. Mean birthweight was 3133+/-430gm. 88.4% of women had good neonatal outcome. 4.79% babies had congenital anomalies and 5.9 % babies were admitted to neonatal intensive care unit.

Conclusion: The accelerated rate of diabetes in pregnancy in this study could be explained by the exponential increase in obesity and lower fasting cut off values for diagnosis of diabetes. Timely induction of labor and caesarean section led to improved perinatal outcomes.

 

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